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Role Description

Do you want to use your experience and knowledge of stop loss insurance documentation support and reimbursement? Join our team and our growing organization with your critical thinking skills and leadership.

The Stop Loss Supervisor Assistant is responsible for managing the daily processes of the department including:

• Initial submission of a stop loss claim with all supporting documentation
• Subsequent submissions of each claim
• Monitoring reports
• Researching reimbursement shortages
• Frequent contact with carriers, clients, brokers, vendors, and internal staff including Marketing, Claims, and Accounting

This position will report to the Stop Loss Manager. Identified gaps should be identified and corrected. The ability to pivot to absorb increasing inventories, set weekly priorities, and reassign as needed to keep up with workloads and daily requirements is essential. Provide clear instruction regarding expectations and priorities of the week to keep inventories in check.

Responsibilities

• Use your experience and our comprehensive training to manage excess loss claim documentation and reimbursement.
• Build relationships and ask the right questions.
• Create or revise procedures to correct gaps on process details or correct process data requirements.
• Collaborate with peers to ensure consistency in processes.
• Communicate with internal and external customers, clients, stop loss carriers, and vendors to gather information pertaining to Stop Loss.
• Respond to various written and telephone inquiries for eligibility, approval/denial determinations, and claim status.
• Juggle multiple tasks without sacrificing deadlines or attention to detail.
• Oversee daily function of the Stop Loss staff.

Qualifications

• High School Diploma or GED
• Basic computer experience and extensive knowledge of the company’s claims process and claims software
• 3+ years excess loss/stop loss experience
• Excellent oral and written communication skills
• Ability to prioritize problems and responsibilities
• Extensive knowledge of medical terminology, procedures, and health insurance concepts
• Ability to understand plan document language accurately as it applies to benefits and apply rules, regulations, and plan provisions to specific situations
• High level of interpersonal skills to work effectively with others
• Ability to manage time and job duties without daily supervision

Requirements

• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Benefits

• Annual salary of 56,200 - 93,600 USD / yearly, depending on relevant factors, including experience and geographic location
• Eligibility to participate in an annual bonus plan
• Comprehensive range of benefits, with a focus on supporting your whole health
• Health-related benefits including medical, vision, dental, and well-being and behavioral health programs
• 401(k)
• Company paid life insurance
• Tuition reimbursement
• A minimum of 18 days of paid time off per year and paid holidays

Company Description

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.